Proximal diabetic neuropathy , better known as diabetic amyotrophy , is a neurological disorder that occurs as a complication of diabetes mellitus. May affect the thighs, hips, buttocks or lower legs. Proximal diabetic neuropathy is a peripheral neuropathy (diabetic neuropathy) characterized by muscle wasting or weakness, pain, or sensation/numbness changes in the legs. Diabetic neuropathy is an uncommon complication of diabetes. This is a type of lumbosacral plexopathy, or a bad condition that affects the lumbosacral plexus.
There are a number of ways diabetically damaging nerves, all of which seem to be associated with elevated blood sugar levels over long periods of time. Proximal diabetic neuropathy is one of four types of diabetic neuropathy.
Proximal diabetic neuropathy may occur in patients with type 2 and type 1 diabetes mellitus, but is most common in type 2 diabetic patients. Proximal neuropathy is the second most common type of diabetic neuropathy and can be treated with time and treatment.
Video Proximal diabetic neuropathy
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The signs and symptoms of proximal diabetic neuropathy depend on the area of ​​the affected plexus. The first symptoms are usually pain in the buttocks, hips, thighs or legs. This pain most often affects one side of the body and can begin gradually or come suddenly. This is often followed by variable weakness in the lower limb proximal muscles. These symptoms, although often started on one side, can also spread to both sides. Weakness in proximal diabetic neuropathy is caused by the denervation of specific muscles that are conserved by the affected plexus regions and thus these muscles can begin to show fasciculations.
Note that diabetic amyotrophy is a condition caused by diabetes mellitus, but is separate from the more common condition of polyneuropathy.
Maps Proximal diabetic neuropathy
Cause
The nerve damage associated with the disease was first thought to be caused by metabolic changes such as endoneurial microvessel disease, which is the degeneration of pericytes due to hyperglycemia, and basement membrane reproduction when pericytes no longer regulate their cell cycle. The reduced lumen size coupled with the absence of pericyte, which regulates capillary blood flow and phagocytosis of cellular debris, causes ischemia. Neural biopsy has shifted the view toward the immune mechanism that causes Micro Vasculitis, which can eventually lead to ischemia. Experimental treatment using immunosuppressive proteins has provided further corroborating evidence on the theory of immune mechanisms. Although this disease does not occur in patients without diabetes, the prevalence is much greater in diabetes indicating that although hyperglycemia does not directly cause nerve damage that may play a role.
Diagnosis
Patients with diabetes and proximal pain and weakness (hips, thighs) are often suspected of having diabetic amyotrophy. A more definitive diagnosis is generally made with electrodiagnostic studies including neural conduction studies (NCS) and electromyogram (EMG). Diabetic amyotrophy is often a diagnosis of exclusion in diabetic patients with lumbosacral plexopathy with no other cause of the lumbosacral plexopathy that can be determined.
Treatment
Proper management of diabetes mellitus can prevent proximal diabetic neuropathy from ever occurring.
The incidence of proximal diabetic neuropathy events is considered to be correlated with blood glucose control in diabetics, and possibly reversible with better control.
Drugs help reduce the pain involved in proximal diabetic neuropathy . Most patients take oral medications prescribed by doctors. Common types of drugs used to treat diabetic amyotrophy include anticonvulsive (eg gabapentin, pregabalin) and opioid drugs, although the latter category is not optimally indicated for neuropathic pain.
References
Source of the article : Wikipedia
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